title: [Mortality and hospital admissions rates and diagnosis among individuals with low income and full health insurance coverage in France, 2009].
abstract: OBJECTIVE
  Complementary Universal Health insurance (CMUC) providing free access to health care has been available in France since 2000 for people with an annual income less than 60% of the poverty threshold. Hospital admission and mortality rates in 2009 were compared between beneficiaries of the general scheme under the age of 60 years with (4.5 millions) or without CMUC (34.1 millions) in 2008 and still alive at the end of the year.
  
  
  METHODS
  Data were derived from the French national health insurance reimbursements and short-stay hospital admissions database for 2009 (80% of subjects under the age of 60 years in France). Rates and relative risks (RR) were standardised for the gender and age.
  
  
  RESULTS
  CMUC beneficiaries had greater overall mortality rates (3.32/1000 vs. 1.36/1000, RR=2.4) for both gender (males RR=2.6, females RR=2.1) and each 10 years age class below 60 years. Standardised hospitalisation rate of CMUC beneficiaries was 17.5% and the rate for non-CMUC beneficiaries was 13.2%. Among CMUC beneficiaries, admissions were significantly more frequent for the following activity groups: toxicology, intoxication and alcohol (RR=3.5), psychiatry (RR=2.8), burns (2.7), respiratory medicine (RR=1.9), infectious disease (RR=2.1), endocrinology and cardiology (RR=1.7), obstetrics (RR=1.6). Their hospital mortality rate was also significantly higher (8.9/1000 vs. 5.1/1000, RR=1.73).
  
  
  CONCLUSIONS
  In this low income population with free access to health care, hospitalisation and hospital mortality rates were higher for many diseases that are more or less known targets for prevention and screening actions.
authors.affiliation: Caisse nationale d'assurance maladie des travailleurs salariés, 75986 Paris cedex 20, France. philippe.tuppin@cnamts.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Tuppin
authors.forename: Pierre-Olivier
authors.initials: PO
authors.lastname: Blotière
authors.forename: Alain
authors.initials: A
authors.lastname: Weill
authors.forename: Philippe
authors.initials: P
authors.lastname: Ricordeau
authors.forename: Hubert
authors.initials: H
authors.lastname: Allemand
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D003953:Diagnosis-Related Groups; D005260:Female; D005602:France; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010343:Patient Admission / Q000706:statistics & numerical data*; D011203:Poverty; D019472:Universal Health Insurance; D055815:Young Adult